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Beyond the Network by Carrie Webber and Dru Halverson

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Categories: Practice Management, HR and Accounting;
Beyond the Network 

Key communication strategies for fee-for-service practices

by Carrie Webber and Dru Halverson

Are you considering transforming your practice into fee-for-service? Now is the time to work diligently on your patient experience. Every interaction is key to building up your patients’ perception of value.

It takes a confident, prepared and practiced team approach to communicating to patients with care while also executing a leveled-up patient experience that exceeds patients’ expectations.

If your plan is to transition away from insurance involvement and into fee-for-service, it is important to plan ahead for a successful shift. Going out-of-network with plans includes proactively planning communication time and outlets with your patients. We suggest this can take six to 12 months when done well.

To support this shift, consider using multiple touchpoints to communicate with your patients. These can include in-person conversations during their appointments, written communication through letters and emails, and discussions over the phone. It’s also helpful to communicate when scheduling appointments and to follow up afterward to ensure clear expectations for future visits. Additionally, use your social media platforms and website to share updates and reinforce key messages.

Practicing the verbal skills for these conversations long before they are necessary helps lay the groundwork for a smooth and successful transition. To have successful conversations with patients, the team must be clear on why the change is happening and the benefits of shifting to out-of-network, and be ready to engage in these patient conversations with competence and confidence.


In-network vs. fee-for-service
If you are trying to determine the pros and cons of being in an insurance network vs. going fee-for-service, inspect what you expect. You must know the truth of your current state of business so you make educated decisions for your practice’s future. Your current collections, accounts receivables and treatment acceptance numbers will show where your business is healthy and where it is struggling and needs stronger execution.
  • Are you tracking treatment acceptance over four months? Aim for 85% treatment acceptance by month four.
  • Are you running aging reports? Your accounts receivable total should be half of your monthly production, and it should be all current—not older than 60 days.
  • Are you monitoring write-offs? Identify how much of your production is being written off because of non-reimbursement or bad debt.
  • Are you monitoring the maximization of patient financing in your practice? A financing utilization report like CareCredit’s “Activity at a Glance” can show you how many applications are coming from your practice and the status of the applications.
These numbers can help guide you on big decisions for your practice. They also drive home the need for strong financial options and collections processes in your practice.


Are you ready for fee-for-service?
Before you make the shift to fee-for-service, make sure you are in the right condition to do so.

Does your practice reflect excellence in customer service and in your patient experience? Patients may choose to move to a practice that takes care of their insurance billing, so customer service is more important than ever before in the fee-for-service model. Your internal processes and skillsets for delivering consistent excellence in these areas need to be sharp. Each team member can make or break the patient’s relationship with the practice and their perception of value for treatment.

Does your team understand and confidently explain payment options?

Knowing this can be the largest barrier to treatment acceptance and completion, it is important you mention financing options early in the patient experience. You still want to make it convenient for patients to pay for care even though you no longer accept insurance benefits.

Are you practicing communication strategies regularly?

Your team should be comfortable discussing objections, finances and how insurance will be handled going forward. Role-playing these conversations improves outcomes. The intentional pursuit of continuous improvement separates the good practices from the great practices.


Introducing the insurance change
As you begin discussing with patients your change of relationship with their insurance program, make sure you address the positive aspects of the change. Know that the “why” is always the motivator of behavior. Stress the why in a positive way—not negative.

Remember, one of the key conversations you will have is when you are face to face with the insured patient at their next appointment. Be prepared, keep the conversation positive and be ready to stress the benefits of your practice, your dental care, your doctor and your team. Here are some two common scenarios:

1. “Mrs. Jones, we are changing our relationship with your insurance company. You may not notice much of a change. We can still file your claim with your insurance company; however, they will send you the insurance reimbursement. We will collect the total payment from you and the insurance company will send a check to you for their portion.”

2. “Mrs. Jones, the amount an insurance benefit pays for a procedure is not based on how much the patient needs that procedure. The amount your benefits cover has little to do with the dentistry you need and more to do with the specifics of your benefits. Therefore, we have selected to go out-of-network with your plan.”


Addressing cost concerns
Patient financing is a tremendous resource for patients to continue to move forward with recommended dental care while supporting the need to make it financially manageable.

Here are some examples that can be practiced and personalized to help address cost as a barrier to care when introducing patient financing:

1. “We work with a trusted third-party financing partner called CareCredit. With this option, you may be able to make monthly payment arrangements over time. This way we can help you fit the investment for your treatment into your monthly budget more comfortably. Many of our patients are using it and love it! Would you like more information about that?”

2. “Mrs. Jones, before I give you the results of my review of your treatment and what I’m recommending for you, let me tell you that if you have any concerns about the financing of your treatment, we have convenient, long-term options available right here in our practice.”


Use active listening
“It sounds like you have some concerns about paying for your dental care.”

“I can understand how you feel.”


Offer solutions
“We have options available for patients to pay for needed and wanted dental treatment. Would you be interested in exploring third-party financing?”

“Are you aware of the varied options we have for you to get the dentistry you need and fit it within your budget?”

In the end, there are three key components of having a strong fee-for-service practice. First, give patients with insurance a reason to stay by delivering the best treatment and best service. Next, give your patients a variety of ways to pay for their treatment. Finally, get out of the way and give your patients the chance to say yes to the very best. That is the basis of a strong fee-for-service, patient-practice partnership.

Author Bios
Jaclyn Nona Carrie Webber is owner of The Jameson Group, a dental management coaching and marketing firm. Webber is a contributing author to several publications and blogs on the topics of dental management, leadership, marketing, customer service and business development, as well as a popular speaker at dental meetings nationwide. She is a member of the Speaking Consulting Network and was named a Leader in CE by Dentistry Today for the past seven years. For more information on Webber and The Jameson Group, visit jmsn.com.


Jaclyn Nona Dru Halverson, RDH, BS, has worked with The Jameson Group for more than 35 years and is currently the chief of Advisor Development where she leads the Jameson team of advisors and the streamlining of Jameson services to ensure great delivery and results every time for every client. She has proven herself as an effective advisor for dental practices nationwide in both the management and clinical aspects of the consultation experience.



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